Provider Demographics
NPI:1881177434
Name:BEIERMEISTER, PATRICK A (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:A
Last Name:BEIERMEISTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OMRO
Mailing Address - State:WI
Mailing Address - Zip Code:54963-1420
Mailing Address - Country:US
Mailing Address - Phone:920-685-5041
Mailing Address - Fax:
Practice Address - Street 1:328 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OMRO
Practice Address - State:WI
Practice Address - Zip Code:54963-1420
Practice Address - Country:US
Practice Address - Phone:920-685-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19392-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist